Abstract

BackgroundSyringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases.MethodsWe performed a qualitative needs assessment of existing syringe services programs in the state of Colorado in 2018–2019 to describe—their activities, needs, and barriers. Using a phenomenological approach, we performed semi-structured interviews with key program staff of syringe services programs (n = 11). All interviews were digitally recorded, transcribed, and validated. A data-driven iterative approach was used by researchers to develop a coding scheme to organize the data into major themes found across interviews. Memos were written to synthesize main themes.ResultsNearly all the syringe program staff discussed their relationships with law enforcement at length. All syringe program staff viewed having a positive relationship with law enforcement as critical to the success of their program. Main factors that influence the quality of relationships between syringe services programs and law enforcement included: (1) alignment in agency culture, (2) support from law enforcement leadership, (3) police officers’ participation and compliance with the Law Enforcement Assisted Diversion (LEAD) program, which provides intensive case management for low-level drug offenders, and (4) implementation of the “Needle-Stick Prevention Law” and Drug Paraphernalia Law Exemption. All syringe program staff expressed a strong desire to have positive relationships with law enforcement and described how a collaborative working relationship was critical to the success of their programs.ConclusionsOur findings reveal effective strategies to foster relationships between syringe services programs and law enforcement as well as key barriers to address. The need exists for both syringe services programs and law enforcement to devote time and resources to build a strong, positive partnership. Having such positive relationships with law enforcement has positive implications for syringe services program clients, including law enforcement being less likely to ticket persons for having used syringes, and encourage people who use drugs to seek services from syringe services programs, which can then lead them to other resources, such as housing, wound care, and substance use treatment programs.

Highlights

  • Syringe services programs provide sterile injection supplies and a range of health services (e.g., Human immunodeficiency virus (HIV) and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases

  • Overview of variation in relationships with law enforcement Participants were asked about their interactions with law enforcement agencies, and all Syringe services provider/program (SSP) staff members discussed at length the relationship with law enforcement

  • SSP staff stated that law enforcement agencies viewed SSPs as a resource for people who use drugs (PWUD) that provided critical services for this population in their community, and valued SSPs and supported their mission

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Summary

Introduction

Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. SSPs take a harm-reduction public health approach, which aims to reduce the negative health effects of substance use [6] In this context, SSPs focus on prevention of the primary sources of morbidity and mortality associated with injection drug use, including preventing infections, transmission of infectious diseases and overdose deaths, rather than abstinence from drug use. It is not surprising that there could be discordance between SSP activities and law enforcement practices

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